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Congenital vesicouterine fistulas—A PRISMA‐compliant systematic review
Author(s) -
Jóźwik Maciej,
Jóźwik Marcin,
Zaręba Kamil,
Semczuk Andrzej,
Modzelewska Beata,
Jóźwik Michał
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23795
Subject(s) - medicine , systematic review , vagina , atresia , anal atresia , gynecology , surgery , medline , political science , law
Aims Vesicouterine fistulas (VUFs) are infrequent abnormal connections between the bladder and the uterine cavity or cervical canal, being mainly sequelae of repeat Cesarean sections. Exceedingly rare are congenital VUFs. This is a systematic review of available world data aimed to characterize congenital VUFs and better understand the mechanism(s) of their formation. Methods The PubMed ® database via MEDLINE ® search engine was explored from its inception to March 2018. Relevant studies were identified using selected Medical Subject Heading‐based terms. This was further supplemented by cross‐referencing and handsearching. Retrieved literature was evaluated in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses, or PRISMA, guidelines. Results A total of 6561 articles were identified of which 10 were analyzed. Three VUFs accompanied broader syndromes of congenital defects. A lack of patency at the level of the vagina was present in all assessed cases. Unilateral renal agenesis was confirmed in four of eight (50%) verified patients. Hence, unilateral kidney agenesis was related to a lesser degree ( P  = 0.0186) than vaginal atresia to VUF. The principal features of these fistulas were as follows: partial or complete vaginal atresia resulting in primary amenorrhea, menouria present since menarche, and urinary continence. Conclusions This review provides the first systematic evidence that congenital VUFs are chiefly associated with concomitant vaginal atresia. The symptomatology of such VUFs is consistent with that of type I acquired fistulas.

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